Individual
DR. LARS C LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 HEART DRIVE, ECU PHYSICIANS FAMILY MEDICINE, GREENVILLE, NC 27834-8944
(252) 744-4611
(252) 744-2056
Mailing address
PO BOX 751069, ECU PHYSICIANS FAMILY MEDICINE, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27479
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51050
BCBS NC
NC
05
—
7951050
—
NC
01
—
80106314
RAILROAD MEDICARE
NC
Enumeration date
08/22/2005
Last updated
10/26/2011
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